Case studies

Case study: Thinking outside the box

Dr Lim’s practice was bulk billing at 98% when she decided she wanted to lift the practice’s income to offer more professional development for staff and to increase her salary. Instead of increasing their opening hours, or increasing their regular fee, they introduced a $10 co-payment just for services delivered between 6–8 pm Monday to Friday and 12 noon–5pm Sunday.

Because the practice billed an average of four Level B consultations per hour per GP, the $10 co-payment resulted in an extra $40 worth of billings per hour, per GP. This amounted to $600 per week, and therefore $28,800 per year per GP. With an average of 40% of GP billings paid to the practice, the practice received an additional $11,520 per year, per GP.

(Options outlined in this example may not be practical for practices in bulk billing incentive areas.)

Case study: practice membership fee

If your patients rely on bulk billing, consider how you can continue to offer this and recuperate costs without losing eligibility for the bulk billing incentive.

You can adapt your billing models to suit you and your patients. If you predominantly bulk bill some or all of your patients, consider directly charging them for a service (at least) once, which allows you to charge an additional annual ‘practice membership fee’ as part of that transaction.

Practices that provide services eligible for a bulk billing incentive may be hesitant to charge patients an out-of-pocket cost because it means the practice forfeits the incentive payment. As a result, the practice would need to charge patients a higher out-of-pocket fee to make up for the loss of the incentive. However, an annual ‘practice membership fee’ may suit the GPs, the practice and their patients.

It could work like this: The practice raises an account for each patient for what would otherwise be that patient’s first bulk billed consultation of the financial year. After that, billing of any particular patient is at the GP’s discretion. The annual fee allows the GP or practice to recuperate the costs associated with providing high quality services, and all subsequent bulk billed services continue to attract the bulk billing incentive.

Example provided by Dr Emil Djakic, GP and Practice Owner in Ulverstone Tasmania.